Postoperative peritonitis after digestive surgery. About 92 cases

92 cases of post-operative peritonitis in digestive surgery are recorded: - Diagnosis is difficult inspite of the multiplicity of symptoms which are variable and non specific. - Clinical presentation is dominated by the frequency of infectious symptoms essentially fever, neuro -psychic, hemodynamic and respiratory disorders. Abdominal signs though advocatory are late. - Early reoperation represents the only possibility of survival for the patients. It must contain a way large, a complete peritoneal washing, an eradication of the source of peritonitis and an effective drainage. - A correct ressucitation effective before, during, and after operation is fundamental. - The prognosis of this fearful complication improves clearly in case of operation and the mortality rate declines from 100% [in absence of operation] to 47.4% [in case of operation]. Because of the high mortality rate, [44.4%], this post-operative complication has to be prevented

Volvulus of the sigmoid colon. Therapeutic strategy. About 38 cases

A retrospective study of 38 cases of sigmoid volvulus is reported. The relative frequency of this pathology among young people in Morocco is noted. In 82% of cases diagnosis was without difficulty; and in two cases an associated small bowel volvulus was found. When deciding on the therapeutic approach it is essential to differentiate between cases in which the sigmoid colon is necrotic and those in which the changes are reversible. In the latter, the authors recommend a non surgical reduction [using flatus tube or better: colonoscopy] with elective surgery performed at later date. If initial reduction proves impossible, colonic resection whith colostomy appears to give the best results